Medical Economist- Senior- Expert
Pay Rate: $61 / hour
Minimum Qualifications
Masters' Degree or extensive medical economist experience exceeding minimum qualifications (includes bachelor' s degree plus experience)
At least three (3) years of experience doing a broad base of senior level medical economic analyses.
A good working knowledge of inpatient and outpatient medical industry operations or claims analysis to identify aberrant billing patterns.
At least two (2) years' experience acting as lead worker on complex medical analyses
High level proficiency in SAS, SQL, data mining software and Microsoft Office Suite, including Access Excel, Power Point and Word.
Experience in accessing using and analyzing complex medical information databases.
(A good working knowledge of Medicaid/Medical Assistance a plus, but not required)
Role Description
Provide leadership in the design and conduct of:
Fiscal and program analyses to support Pennsylvania Medical Assistance Program decision-making processes.
Analyses to support medical assistance business operating decisions and for tracking, reporting and controlling of Medical Assistance costs.
Analyses to support the development of effective provider network management, reimbursement systems and strategies or identification of abuse or waste in the Medical Assistance program.
Cost benefit analyses for new Medical Assistance initiatives
Medical Assistance cost trend analyses by geography, services provider type, place of service and other factors to Client trends and suggest action plans.
Fiscal and impact analysis of potential cost containment
initiatives
Extract and analyze large data sets and perform analyses to determine whether targeted cost savings were achieved or identify future savings targets
Perform analysis of various data sets, recommend payment levels and provide fiscal impact estimates Development and maintenance of healthcare payment reconciliation systems Participate in meetings to advise Commonwealth staff on work results.
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